Results
The mean age of the patients was 108.64±65.61 months (1.5 months-18
years). Of the patients, 51.4% (54/105) were male. There were 13
patients in Group 1, 46 patients in Group 2, and 46 patients in Group 3.
The most common cause of transmission in pediatric patients was
contacting with a family member diagnosed with COVID-19 (n=91, 86.7%).
Four of our patients (3.8%) had an accompanying disease at the time of
diagnosis. A 16-year-old patient had more than one comorbid factor
(Diabetes Mellitus + Beta thalassemia major + chronic respiratory
disease). A 5.5-month-old patient was followed-up for Primary
Hemophagocytic lymphohistiocytosis before the diagnosis. One of whom
with Down syndrome and Acute lymphoblastic leukemia, and the other with
the diagnosis of epilepsy and was on anti-epileptic drugs.
The most common admission complaints were dry cough (n=17, 16.2%),
fever (n=16, 15.2%), lassitude and fatigue (n=14, 13.3%) and headache
(n=12, 11.4%), respectively. The admission complaints of the patients
were summarized in Table 1.
Chest CT was performed on 48 patients. Pulmonary ground-glass opacities
(n=11, 10.4%) were the most common chest CT findings detected in these
patients (Fig. 1, 2 ). Other common findings were local patchy
shadow (n=5, 4.7%) and bilateral patchy shadow (n=4, 3.8%),
respectively. Pleural effusion was also seen in one of our patients.
A significant number of patients were clinically asymptomatic (n=59,
56.2%). Three patients required intensive care. The classification
based on clinical severity was summarized in Table 1. The mean length of
hospital stay was 4 (range 1-19) days in the patients who required
hospitalization. No mortality was observed in any of our patients.
Antibiotics and antiviral agents were used to treat the patients. The
most commonly used drugs were the combinations of azithromycin (n=72,
68.6%), hydroxychloroquine (n=21, 20%), antibiotics (n=10, 9.5%),
oseltamivir (n=8, 7.6%), lopinavir-ritonavir (n=4, 3.8%). Only 3 of
our patients required the use of oxygen. High flow oxygen was
administered to a patient who required intensive care.
The clinical and laboratory findings of the patients were summarized in
Table 2.
According to the differences between Groups 1, 2, and 3, the contact
history was significantly lower in Group 1 than in other two groups
(p<0.001). The frequency of male gender was significantly
higher in Group 2 (p=0.032) than in other two groups. Besides, sore
throat and cough complaints were significantly higher in Group 3 than in
other two groups (p=0.004, p=0.008) (Table 3).
The distribution of the clinical severity of the patients by age groups
was shown in Table 4.
The Wbc and D-dimer levels, lymphocyte, and platelet counts were
significantly higher in the patients in Group 2 compared to other two
groups (p=0.007, p<0.001, p0.001, p=0.005). The creatinine
levels were lower in the patients in Group 1 than in other two groups
(p<0.001), and the blood urea levels were lower in the
patients in Group 1 than in the patients in Group 3 (p=0.048). The
parameters that showed significant differences among the groups
regarding the evaluation of the laboratory findings were shown in Table
5.
There were significant positive correlations between length of
hospitalization and CRP, ferritin, fibrinogen, Body temperature
(r=0.871, r=0.400, r=0.648, r=0.585, p<0.001, p=0.021,
p<0.001, p<0.001, respectively) and negative
correlations with oxygen saturation, (r=-0.765, p<0.001). We
modelled a multiple linear regression analysis with enter model to
define the independent variables of duration of length of hospital stay.
Gender, CRP, ferritin levels, fibrinogen, oxygen saturation were
included into the analysis. CRP was only independently factor associated
longer duration of hospitalization (p<0.001, table 6).